Iranian Journal of Radiology
Volume:20 Issue: 3, Jul 2023

Intracranial chondroma and chondrosarcoma are very rare tumors that mainly originate from the base of the skull. Advanced neuroimaging studies, including magnetic resonance spectroscopy (MRS), play a pivotal role in both tumor diagnosis and presurgical planning.

We present two cases of intracranial cartilaginous tumors, including a chondroma and a chondrosarcoma, both of which presented with severe headaches. Due to inconclusive conventional MRI and MRS results, they were both primarily diagnosed as intra-axial brain tumors. However, pathological reports later confirmed the diagnosis of a chondroma and a chondrosarcoma.

Based on the present findings, the use of advanced neuroimaging techniques, such as MRS, may improve diagnostic accuracy. We believe that MRS can play a significant role in the surgical planning of similar cases. Also, reporting rare cases worldwide can contribute to the improvement of radiographic diagnosis.

Solitary fibrous tumors (SFT) are rare soft tissue tumors with a typically benign clinical course; however, up to 35% of SFT exhibit metastasis, resulting in a poor prognosis. The management of hepatic metastasis of SFT is yet to be established because of its rarity of cases.

Herein, we report the clinical results of 13 transarterial chemoembolization (TACE) sessions for hepatic metastasis in 5 patients with SFT.

Patients with hepatic metastases from SFT who underwent TACE between May 2005 and April 2021 were retrospectively reviewed. Tumorresponse was evaluated using the modified response evaluation criteria in solid tumors (mRECIST).

Five patients (one male, mean age: 59.2 years) underwent 13 TACE sessions, resulting in four partial responses (PR, 30.8%), four stable disease cases (30.8%), and five progressive disease cases (38.5%). No severe complications occurred. Four of seven sessions (57.1%) of selective TACE showed partial response (PR). The mean progression-free survival (PFS) was 2.3 months (range: 0 - 8 months), and for sessions with PR, the mean PFS was 6.3 months (range: 3 - 8 months). The mean overall survival was 32.7 months (range: 18 - 44 months).

This report suggests that TACE might be a potentially safe treatment option for hepatic metastasis of SFT, and it could offer a benefit in controlling local tumor growth in cases where selective TACE is applicable.

Dual-energy computed tomography (DECT) scan has been proposed as an effective modality for determining the chemical composition of renal stone subtypes.

This study aimed to evaluate and compare the efficacy of DECT in the identification of renal stone type and composition versus biochemical analysis as the gold standard.

The type of 146 renal stones, removed from patients by surgery, was determined in a medical laboratory. The stones were then inserted into the kidney of an anthropomorphic Rando phantom, and DECT scans were acquired. The stone type, specified by the scanner software, was compared with the results of biochemical analysis as the gold standard.

The DECT scans showed acceptable accuracy in identifying the chemical composition of renal stone subtypes. Based on the comparison of biochemical analysis and DECT results, the accuracy values for cystine, uric acid, and calcium-oxalate stones were 97%, 100%, and 97%, respectively.

Based on the present results, DECT could detect pure uric acid, cystine, and calcium-oxalate stone types with high sensitivity. However, for mixed stones, the stone type, directly identified by DECT scan, was not reliable.

Context: 

Idiopathic granulomatous mastitis (IGM) is a benign inflammatory condition of the breasts with an unknown etiology, which can mimic breast cancer on conventional ultrasound (US). Other imaging modalities, such as mammography and magnetic (MRI) resonance imaging, cannot efficiently differentiate this condition from malignancies. Elastography is a novel imaging technique used to evaluate tissue elasticity.

This systematic review aimed to investigate the imaging features of IGMon elastography and also to determine whether this modality is useful for distinguishing IGM from other breast lesions.

Acomprehensive literature search was conducted across several databases, including Medline, Embase, Cochrane Library, Scopus, and Web of Science, in October 2022. The Joanna Briggs Institute (JBI) critical appraisal tool was used for the quality assessment of the studies.

After screening 851 articles, seven studies investigating ultrasound elastography (USE) were found to meet the inclusion criteria. Regarding the quantitative findings, both the strain ratio (SR) and shear wave velocity (SWV) were observed to be higher in malignant masses as compared to IGM. Additionally, qualitative scoring systems, such as the Tsukuba and Tozaki classifications, assigned higher scores to malignant lesions. Five of the included studies in this review proposed a specific cut-off point for differentiating IGM from malignancies, using either SWV, SR, or elasticity scores (ES). In four of the studies, these criteria exhibited sensitivity and specificity of approximately 90%.

The current findings suggest that USE can serve as a valuable tool for distinguishing IGM from breast malignancies. By potentially reducing the number of unnecessary tissue biopsies, this modality may lead to a more efficient patient evaluation process.

Changes in signals and parameters of time-signal intensity curve (TIC) resulting from dynamic MRI have been considered for determining malignancy. However, the specific diagnostic criteria of TIC for detecting malignancy in various organs, such as lymph nodes, are not yet well-established.

This study aimed to evaluate the role of some TIC parameters in identifying malignant cervical lymph nodes. Patients and

In this case-control study, patients with cervical lymphadenopathy were examined by dynamic contrast-enhanced MRI (DCE-MRI) before excisional biopsy. They were then divided into malignant and benign groups based on histopathology. Malignant patients were considered as the case group, while benign cases were considered as the control group. The TIC parameters included the signal intensity (SI) at 45 seconds, 90 seconds, 120 seconds, 5 minutes, and 10 minutes, as well as maximum signal intensity (SImax), the time at which the maximum signal intensity occurs (Tmax), the peak signal intensity (SI peak), and the time at which the peak signal intensity occurs (T peak). Additionally, the enhancement slope (ES), washout ratio (WR), and washout slope (WS) were evaluated at 5 and 10 minutes.

A total of 63 patients were enrolled in the study, including 31 (49.2%) patients with benign lymphadenopathies and 32 (50.8%) patients with malignant lymphadenopathies. Among the variables under study, significant differences were observed between the malignant (M) group and the benign (B) group in terms of the SI-5 min, SI-10 min, WR-5 min, WR-10 min, and WS-5 min (SI-5 min: 124.4 ± 145 (B) vs. 219.2 ± 93.8 (M), P=0.003; SI-10 min: 109.9 ± 134.6 (B) vs. 188.9 ± 83.7 (M), P = 0.007; WR-5 min: 0.58 ± 0.38 (B) vs. 0.15 ± 0.13 (M), P < 0.001; WR-10 min: 0.63 ± 0.36 (B) vs. 0.26 ± 0.17 (M), P < 0.001; and WS-5 min: 0.93 ± 1.20 (B) vs. 1.40 ± 4.44 (M), P = 0.001). In the ROC curve analysis, WS-5 min showed specificity of 29.1%, 75%, 90%, and 95% and sensitivity of 88.2%, 70.6%, 47.1%, and 47.1% at cutoff points of 0.1, 0.37, 0.57, and 0.66, respectively.

The WR-5 min can be considered as a potential TIC index in DCE-MRI for the diagnosis of malignant cervical lymphadenopathies.

The incidence of malignant tumors causing bone metastasis was increasing. Therefore, it was urgent to treat patients with bone metastasis.

This study aimed to evaluate the role of CT-guided microwave ablation combined with cementoplasty in the treatment of patients with bone metastasis. Patients and

A total of 20 patients with bone metastasiswhowere treated with CT-guided microwave ablation combined with cementoplasty were included in this study, according to the inclusion and exclusion criteria. The follow-up data of all patients were collected, and no patients were lost to follow-up during this period. The Quality of Life Questionnaire-Bone Metastases Module 22 (QLQ-BM22), the EuroQOL Five-Dimension Questionnaire (EQ-5D), and the Quality-Adjusted Life Year (QALY) measure were used to assess the treatment effects.

Based on the results, 37 operations performed on 20 patients were successful. Minor complications were observed in seven cases. There were significant differences in the QLQ-BM22 scores when comparing the pre-treatment and post-treatment results (P < 0.05). Moreover, the pre-treatment and post-treatment QALY scores exhibited significant differences (P < 0.05). However, there was no significant difference between the pre-treatment and post-treatment EQ-5D scores (P > 0.05).

The combination of CT-guided microwave ablation with cementoplasty was proven to be an effective approach in extending the survival time and enhancing the quality of life in patients with bone metastasis.

Autoimmune pancreatitis (AIP) is often misdiagnosed as pancreatic adenocarcinoma (PAC), resulting in unnecessary surgical interventions. On computed tomography (CT) scans, the capsule-like rim is an essential radiological characteristic for differentiating AIP from PAC. It presents as a hypoattenuating halo surrounding the pancreas. However, this characteristic is infrequently observed in ultrasonography.

The aim of this study was to assess the accuracy of the thickness measurement of the capsule-like structure surrounding lesions during ultrasonography in order to distinguish between AIP and PAC.

This case-control study was conducted on 19 patients with type 1 AIP (AIP1) as the case group and 37 patients with PAC as the controls. The ultrasound images of these patients were obtained from our institute’s database. The thickest part of the hyperechoic capsule-like structure around lesions was identified and measured on the workstation retrospectively. The difference in the thickness of the capsule-like structure between AIP1 and PAC was compared in all lesions and mass lesions, respectively. The optimal cut-off thickness was determined by the maximum Youden index (calculated as sensitivity + specificity - 1). A P-value of < 0.05 (or < 0.05/3 after applying the Bonferroni correction) was considered statistically significant.

All lesions appeared hypoechoic, and there were no significant differences in gender, age, abdominal pain symptoms, jaundice, or weight loss between the case and control groups (P > 0.05). However, there was a significant difference regarding the involved pancreatic location (P = 0.008). Among the lesions, 46 were mass lesions. The hyperechoic capsule-like rim was thicker in the case group compared to the control group for all lesions (mean = 0.40 ± 0.12 vs. 0.32 ± 0.09 cm, P = 0.006) and also for mass lesions (mean = 0.41 ± 0.13 vs. 0.31 ± 0.09 cm, P = 0.006). The cut-off thickness for AIP1 was estimated at 0.41 cm, according to the maximum Youden index in both all lesions and mass lesions. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and odds ratio for all lesions were 0.58, 0.86, 0.77, 0.69, 0.80, and 8.80 (95% CI: 2.37 – 32.64), respectively. In mass lesions, the corresponding values were 0.58, 0.88, 0.80, 0.64, 0.86, and 10.50 (95% CI: 2.23 – 49.52), respectively.

Patients with a hyperechoic capsule-like rim thickness of 0.41 cm during ultrasonography are more likely to have AIP1. This finding holds valuable clinical significance in differentiating between AIP1 and PAC.

Citation is being increasingly used as a key performance indicator in research policies and evaluation systems.

This study aimed to investigate the factors affecting the citation status of clinical articles published in the Iranian Journal of Radiology (IJR).

This cross-sectional study, conducted during May-June 2023, employed bibliometric techniques and investigated the IJR website and the Scopus database. The analysis encompassed various characteristics of the published papers, such as citation status, number of authors, sample size, page count, number of references, year of publication, type of paper, scope of the paper's title, study design, number of articles by the first and corresponding authors in Scopus, h-indices of the first and corresponding authors in Scopus, and nationality of the first and corresponding authors. The citation status was considered as the dependent outcome in the analysis, with a significance level set at P < 0.05.

From 2018 to 2022, the IJR published 357 papers, with an average citation rate of 33.6% and an impact factor of 0.9. The majority of journals citing the articles (36.03%) were ranked in the second quartile according to the Scopus Cite Score Index. The citation status was found to be significantly influenced by several factors, including the study design, scope of the paper's title, type of article, number of years since publication, number of articles by the first and corresponding authors in Scopus, as well as the h-index of both the first and corresponding authors in Scopus (P < 0.05). The results of multiple logistic regression analysis revealed that only the number of years since publication, type of paper, and scope of the paper's title were significantly associated with the citation status.

The present research indicated that the number of years since publication, type of paper, and scope of the paper's title were the most significant factors influencing the citation status of papers in the IJR. These findings provide valuable insights into the citation patterns of articles in the IJR and can help authors and policymakers develop strategies to enhance the visibility and impact of their research.